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Baby not eating. Lactation consultants stumped!

Hi all, I'm new to posting but have been scouring the forums for weeks. I've reached the point where I really need some advice and support from all you smart mamas out there. I apologize for the long post but want to share all of the things I've tried.

I have a sweet 13 week old son who is 12 lbs 10 oz. We had a very lucky and wonderful start to breastfeeding. He has a great latch and strong suck and after the first couple days, everything fell into place wonderfully. He was diagnosed with reflux at 2 weeks old, but still ate well and gained on average an ounce a day. The reflux is much better now and he has minimal spit up. (Yay!)

Around 8 weeks old, he started getting very fussy while breastfeeding - kicking, pulling on and off, and often crying. I spent a couple weeks trying everything I could think of or read about. I'm still on maternity leave so I'm able to spend all day everyday with him (which is lovely), but my whole life has become wrapped up with if he will eat and how much.

I let him nurse whenever he wants for as long as he wants. After the first letdown finishes, he appears to get frustrated and impatient - or just bored and stops eating - even if it's just a little bit of milk. I have tried heating compresses, hot showers, relaxation techniques, lots of skin to skin, breast compressions, etc. But he usually only eats a little bit and then pulls off and won't re-latch. We were in a cycle of trying to eat, him crying, me calming him, and trying again. After about 10 days we started to notice greenish poop, his wet diaper count went down and he started losing weight. We went to a lactation consultant multiple times (and have since talked to others as well) who concluded my milk supply had dropped. Probably from his fussiness and not eating - a vicious cycle.

We have tried a "nursing vacation" many times over the past few weeks. Unfortunately it usually ends with him losing weight and me beginning to worry my supply is dropping more. He will only eat a tiny amount and then stop. Either fall asleep or get angry or even just not look interested at all. And if he goes too long doing that he will eventually get hungry and fuss and scream and not latch at all. This would go on all day.

I tried a number of things to boost my supply. Pumping a lot, pumping right after nursing, power pumping, fenugreek, skin to skin, oatmeal, mothers milk tea, brewers yeast, carrot juice, v8 fusion, fennel essential oil and nursing as often as possible with no more than three hours between. I believe I'm eating plenty (more than I was before) and I drink 8-10 glasses of water a day. Sometimes it does seem to be a supply issue as I'll pump after I nurse and not get anything or I won't hear him swallow much when he is trying to nurse. I know I used to pump more. Other times it seems to be a behavior issue where I know I have milk but he just won't latch ( whether he's too overtired, sleepy, impatient or just not interested - even when I know he's hungry). What confuses me most is pumping seems to be counterproductive to me - any time I pump to drain my breasts he won't eat at the next feeding. After I did a few days of the power pumping hour (10 min on, 10 min off for 60-90 minutes ), he wouldn't nurse at all for several feedings afterwards. It seems he only likes to nurse when I'm really full - overnight and mornings. Fenugreek helped my supply but it made me very sick (dizzy and lightheaded) so I had to stop taking it.

We've taken him to the pediatrician who said he looked healthy besides his weight. (no thrush, no ear infections) I had bloodwork done myself and everything came back normal.

The only thing that I've found to work is to let him nurse (if he will at all), and if he still seems hungry afterwards to pump a short time (so he won't fuss at the next feeding) and supplement him with expressed milk. If he doesn't nurse at all, I do a long pump session. We've managed to get him gaining doing that. If we let him nurse at his own rate, he won't gain. When he refuses to nurse all together, I end up giving him a bottle of milk and then it'll end up being bottles the rest of the day because he won't nurse again when I pump that much. I can't always pump enough to keep up with the bottles so every couple days I will have to give him an ounce or two of formula. With the EBM supplementation, he is currently having about 5-6 wet diapers per day but they are less wet than they used to be.

I'm still looking into more things to increase my supply. I'm starting motherlove more milk (without fenugreek) and going to an acupuncturist (never been before but what the heck!)

So my question is - does this sound like low supply? My body seems slow to regenerate milk for the next feeding. Any advice on other ways to increase it? Nursing constantly doesn't seem to work for us as he simply won't do it. Either I let him eat as much and as long as he'd like and he is less fussy but loses weight (not an option!) or I give him bottles and deal with the fussing on the breast (due to pumping). Are there things I could do differently? I was thinking of doing a couple days of pumping every 2 hours to build up my supply and just giving bottles but I worry about him getting used to the faster flow and refusing the breast all together. The lactation consultants are stumped as to why he's not eating and I worry my supply will drop more. It breaks my heart - I could go to exclusively pumping, but especially since I'm home with him all day I would love to figure out how to get him back to the breast.

Any advice? Or simply words of encouragement would be appreciated. I feel very alone in this journey as every expert I've turned to doesn't know what to do so just ends up leaving me on my own to figure it out! I'm very determined to figure this out, but after 5 weeks, I'm getting exhausted and feeling pretty down. Thanks in advance for any advice (and sorry for the long post!)

Re: Baby not eating. Lactation consultants stumped!

Welcome to the forum!

I'm not surprised the LCs are stumped. This is a tough one! In general, all that is necessary for a baby to gain weight and maintain a good supply in mom is to allow him to nurse on demand, but for some reason this isn't working for your baby. So, why not? Here are some possibilities, with some questions attached:
- Baby isn't able to transfer milk well. How does nursing feel? And has baby been very carefully checked for lip and tongue ties? Can he stick his tongue out over his lower gums?
- Baby isn't nursing often enough. When left to his own devices, how many times does baby nurse in a 24 hour period? Does he sleep for a very long stretch at night?
- Baby isn't willing to nurse. Perhaps he has outgrown his dosage of reflux meds, or needs a different medication? Has he had a thorough physical examination?
- Baby has grown accustomed to eating from a bottle, and now expects his meals to be delivered that way, leading him to become a lazy eater at the breast. Have you tried supplementing him in ways other than a bottle, e.g. finger feeder, syringe, at-the-breast supplementer?
- Baby actually is able to get enough to gain from nursing alone, but has not been weighed properly. Has your baby always been weighed on the same scale at the doctor's office, in the nude? Or are there a variety. Of scales and states of dress/undress in the mix?

I am sure you are exhausted at this point, as you've been doing way above the normal amount of work for the last 13 weeks! I think the good news buried in all the bad news is that you obviously have the capacity to produce plenty of milk, because your baby gained well from nursing alone during his first weeks. And you clearly have the dedication that it takes to get over a big nursing hurdle, or you wouldn't have made it this far!

Here's what I would do at this point:
- Nurse as much as possible. A minimum of 8x per day, more if possible.
- Get a great pump. I'm thinking you want a hospital-grade rental with properly sized shields.
- Pump for 10-20 minutes right after nursing. I know your baby seems more likely to reject the breast when you pump, but emptying the breast is really the only way to increase supply. Herbs, tinctures, oatmeal- they don't do 1/10th as much as frequent and complete emptying. When a mom feels like she is "slow to regenerate milk" it's almost always due to a lack of demand- her body isn't getting the stimulation it needs in order to start refilling the breast more rapidly.
- If daytime pumping results in increased breast rejection from the baby, try to pump at night when baby sleeps? IDK, this is a tough one- you need your sleep, too!
- If the above doesn't work, I think a good plan B would be to nurse as much as possible, pump like a maniac all day long, and do bottles whenever the baby won't nurse- but don't lock yourself into a mindset that it's going to be bottles only during the day while you are working on pumping.

I know that what I am suggesting is exhausting- trust me, I have done it!- and there's no shame if you decide you just can't go down this path.

Re: Baby not eating. Lactation consultants stumped!

I agree with mommal, but I have a couple more ?

Was baby examined for tongue and/or lip ties ruled out? Sucking issues? Any before and after nursing weight checks?
When you say baby lost weight, you do mean that baby actually lost weight, not only went down on the growth charts? (Sorry, Just checking, sometimes moms report weight loss when baby is actually gaining but going down the charts.)

Did you ever try using a lactation aid for supplementing? These can be a good way to supplement baby that does not adversely affect the nursing relationship as much as bottles might. It also allows mom to instead of doing nurse, pump, and bottles, to nurse and pump, no bottles, so it makes for one less step. here is a little info http://cwgenna.com/smartnothard.html

We've taken him to the pediatrician who said he looked healthy besides his weight. (no thrush, no ear infections) I had bloodwork done myself and everything came back normal.

Do you mean you had bloodwork done on you, or on baby? If on baby, how extensive was it? I am not a doctor, but it is my understanding that some times a baby won't gain or will lose weight due to underlying illness, conditions, or nutritional deficiencies. These are not always going to be obvious. Underlying issues might also cause a baby to not want to eat. Sometimes we are talking a serious health issue, sometimes it is something more simple like anemia. It sounds as if your baby does not even want to eat to some degree. It makes little sense that an entirely healthy baby would let himself starve when food is available, and while I think milk production may be part of the issue at this point, it seems odd that all was going well until 8 weeks and then not. Established Milk production does not typically just go away unless something has happened to make that happen.

As far as uping your production, besides the frequent milk removal, Since fenugreek worked but made you feel ill, have you researched or tried other herbal galactagogues in oral form? some that come to mind are Blessed thistle,? Goats rue? Shatavari?
Have you considered a prescription galactagogue? I am not sure what is in motherlove more milk, it may contain some or all of these. But dosage matters too.

Also I suggest the book The Breastfeeding Mothers Guide to Making More Milk.

The only thing that I've found to work is to let him nurse (if he will at all), and if he still seems hungry afterwards to pump a short time (so he won't fuss at the next feeding) and supplement him with expressed milk. If he doesn't nurse at all, I do a long pump session. We've managed to get him gaining doing that.

If you are able to make enough milk during the course of one day for baby to eat enough in one day, then that means you make enough milk. The issue then becomes more of why baby won't or can't transfer enough milk for himself.

For support I can only tell you that I have never met a mom who regretted the efforts she put into being able to nurse or baby and/or provide her baby with her own milk. If the effort becomes unworkable for you and your family, I think you will know that in your heart and have peace with your decision to stop. Until then, it is worth it to keep trying. Also, breastfeeding (and breastmilk feeding) need not be an all or nothing proposition. Even if you cannot exclusively nurse, you can provide your baby with your expressed milk while nursing continues. If nursing can no longer continue, you can continue to provide your own milk. Even if baby requires formula or donated milk supplements, you can give your baby whatever milk you are able to make. And even if baby never has one more drop of your milk, you have given baby a great start in life by nursing as long as you have.

Re: Baby not eating. Lactation consultants stumped!

Thank you so much for the quick replies! it means a lot to me to have the help!

To answer your questions:

- Nursing feels fine to me. I've been lucky to not have pain after those first couple days.
- He hasn't been checked for tongue or lip tie. Thats a good point. But he often sticks his tongue out at me and it reaches out past his lips so I'm guessing it's ok? his suck is strong.
- When left up to him, Im actually not sure how often he would nurse. I almost always end up feeding him when it reaches three hours because he's either sleeping or not acting hungry. There are some times when he will fuss to eat, but the only time he really acts hungry is when he wakes up in the night and in the morning. (he smacks his lips - its quite funny)
- we used to wake him after four hours at night to feed him. because of his reflux he did better with small meals so we didn't let him sleep longer. however, because his reflux is better and i found he was often too sleepy to nurse when we woke him, we are now letting him sleep until he wakes up. he eats much better that way, but we end up sometimes losing a feeding by doing that. he will typically go 5-6 hours for the first stretch of the night.
- we did just take him to a GI doctor for his reflux who thought it seemed to be in check with his medications. he no longer acts like he's in pain when he eats or spits up. we did increase his meds once but they seem to be ok right now.
- as far as getting used to a bottle, i think that may be part of it. my best guess is he's part lazy (the LC said that his first day in the hospital), and part picky. My mom said i was picky and wouldn't breastfeed so she had to switch me to formula at 6 weeks. i haven't tried any other feeding devices. The lactation aid sounds really interesting. Our LC said he would probably just learn to suck on the tube, but i think it'd be worth trying. have you heard of babies out-smarting the tube? can you control the flow with it?
- as far as weighing him, we rented a scale when he was diagnosed with reflux 11 weeks ago. we weigh him at the same time every night right after a diaper change. we would celebrate every ounce gained so we are pretty diligent about it and noticed when he started losing weight. we did do the before and after weight checks a few times and he seemed to eat about an ounce
or so before giving up.
- about the bloodwork - i had my blood tested to look for thyroid, anemia, blood sugar, etc. i have not had baby's blood tested. our pediatrician kind of just said - oh just pump and give him bottles. she didnt think anything was wrong, but i agree it seems so weird it came out of nowhere when he was such a nursing champ before then. are there certain things you know of that we should research or read about? things to ask the ped to look into?
- i will look into those herbs. i believe some of them are in the motherlove more milk, but need to double check. My LC recommended domperidone, but it makes me a bit nervous.

I really appreciate the suggestions. I spent today in a cycle of try-to-nurse as much as baby would, pump while husband gave bottle, wait 45 min and pump again, repeat. Baby did fine in the morning feeds doing that but by the afternoon, he was not having it - my supply was just too low for him to work for it. however, I was able to get in some good pumping time with my husband's help - it will be a challenge during the week! How long does it typically take to start to see an increase? i will definitely be looking for a hospital grade pump to rent as well! great suggestion.

and thank you for the kind, supportive words. i didnt realize how much i need that encouragement to keep going! especially those times when my husband snuggles with the baby while im hooked up to a darn machine pumping!

Re: Baby not eating. Lactation consultants stumped!

He hasn't been checked for tongue or lip tie. Thats a good point. But he often sticks his tongue out at me and it reaches out past his lips so I'm guessing it's ok? his suck is strong

This may be a long shot, but I think it is important to always rule out a physical cause like this. As far as being able to stick tongue out, no, that does not rule out tt.

The lactation aid sounds really interesting. Our LC said he would probably just learn to suck on the tube, but i think it'd be worth trying. have you heard of babies out-smarting the tube? can you control the flow with it?

Yes sometimes baby will 'outsmart' the tube and just suck on the tube.
On the other hand, lactation aids are a tried and true method for supplementing in a breastfeeding supportive way and are recommended for that purpose by many breastfeeding experts. Yes you can control the flow. If you hold the bottle or bag higher than the breast, gravity will make the milk flow, If you do not, then negative pressure from sucking will make it flow. I am sure there is more to it, and would suggest talking to your LC and asking if she knows someone else that can give you more in person guidance with a lactation aid. You can also research it yourself. Jack Newman has an article and video aside from the article I linked above, also you can find more info from the manufacterers Medela (SNS) and LactAid (Lactaid.)

as far as weighing him, we rented a scale when he was diagnosed with reflux 11 weeks ago. we weigh him at the same time every night right after a diaper change. we would celebrate every ounce gained so we are pretty diligent about it and noticed when he started losing weight. we did do the before and after weight checks a few times and he seemed to eat about an ounce
or so before giving up.

Who gives up? YOu or baby? Yes, an ounce is a small feeding for this age-but it not an abnormal feeding. Feeding sizes vary, and many babies snack or cluster nurse in order to get enough. Daily weight checks can be misleading. Why did you guys get the scale? Were there weight gain concerns at that point? Do you mean his weight goes up and down, or is on a steady downward path?

our pediatrician kind of just said - oh just pump and give him bottles. she didnt think anything was wrong,

But there clearly IS something wrong. A baby should be able to gain normally by nursing. If they cannot, something is WRONG. "Just pumping and giving bottles" is much easier said than done, and the AAP is clear that doctors should be helping mothers breastfeed, not shrugging off their concerns by telling them to bottle feed. I suggest talking to your doctor again or seeking a second opinion.

Re: Baby not eating. Lactation consultants stumped!

Thanks for the reply.

We went to the pediatrician again today who looked him over and thinks he is fine. She once again suggested pumping and feeding via bottles which, as you noted, is REALLY hard to do! Especially because I'm just not ready to give up on breastfeeding so I'm trying to do both - nurse and pump. It's exhausting, but I'm determined to find a solution. We will be getting a second opinion since I don't think we are getting the support we are looking for to make sure nothing else is wrong.

Originally Posted by @llli*lllmeg

Who gives up? YOu or baby? Yes, an ounce is a small feeding for this age-but it not an abnormal feeding. Feeding sizes vary, and many babies snack or cluster nurse in order to get enough. Daily weight checks can be misleading. Why did you guys get the scale? Were there weight gain concerns at that point? Do you mean his weight goes up and down, or is on a steady downward path?

Oh, the baby gives up. And I mean he throws a screaming tantrum kind of giving up. When this happens I will calm him down (I don't want him to associate breastfeeding with that negativity), wait a little bit and try again. Sometimes he'll eat a little bit again after a while, sometimes he needs a nap first and sometimes he just screams again.

We got the scale to monitor his weight with the reflux. He was spitting up a lot and the doctor wanted to make sure he was gaining (he also lost a lot of weight his first week out of the hospital so she was being sensitive to that). We know not to live and die by the daily weight check as it can fluctuate a bit, but he was pretty consistent for 2 months - he either stayed the same or gained up to 1.5 oz every day. When this fussy trend started, he started going down over the course of about 10 days. It was a trend that correlated with his drop in wet diapers and increase of greenish poop so we knew the fussiness was starting to impact him.

As you know, I've tried a bunch of things over the past 5 weeks and every now and then I'll try a "nursing vacation" for a couple days with him to see if it goes any better. Each time he gets fussy again and ends up losing weight. After my nurse and pump marathon for three days, the last two days I wanted to try again. I have held him throughout the day and just offered the breast whenever he wasn't sleeping. The good news is he has eaten for the last two days with only one fussy fit (which after an hour nap he did much better). The potentially down side (although too early to tell), is that he lost 2 ounces in these days (although he had some GIANT poops that had been building up for the past week so that probably had a lot to do with it). He has had wet diapers today, but they're not soaking wet. I will try again tomorrow and see if he does better. It is so nice to see him nursing - now if only he'd eat more! Is it possible that he's simply just not a hungry baby? Do those exist? He rarely shows hunger signs at all, but I just keep offering. Or maybe it really is a supply issue... it's just so confusing.

I read about the lactation aids and have ordered a LactAid to see if that will help us out. I feel like we are so close to figuring something out!

Re: Baby not eating. Lactation consultants stumped!

samiam-- i don't have the wisdom that these ladies have, but I just want you to know that I went through almost the exact same thing with my firstborn who is now 3. I totally understand your frustration because everyone seemed to think I was trying way too hard and I should just forget it and give him a bottle. I was very very determined to BF and I actually nursed him for 18 months. Eventually we figured out our own little system. Some days he nursed fine and other days he drove me crazy. But to be honest, he eats the same way now as he did as an infant. He will eat when he wants to eat (which I totally don't get because I love to eat). Feeding him has been a struggle since day 1. I will say that it is easier now because he can tell me "I'm hungry" or "I'm not hungry" or "I want yogurt not apple slices", but I wanted to post here to let you know that you are not alone and it was a very long first year of motherhood for me. It kind of became my own private battle to get him fed. The forums here were great for support. I didn't always post, but I would read everything and it was nice to know other people were struggling with breastfeeding-- not always similar to my situation, but misery loves company Whatever way you end up feeding him, you are doing an amazing job right now. Take it one day at a time. Keep up the good work!!!

Re: Baby not eating. Lactation consultants stumped!

I also cannot contribute to the fantastic advice you have had so far but, like previous post, I also experienced something similar. My little boy suddenly started crying when I tried to nurse him from around 2 months of age. He dropped down on the charts and the only way I could get him to eat was at night at walking around with him whilst feeding in the day (gosh, the things you do as a breastfeeding mom!)

I just had to wait it out with him in the end - he's still not keen on being still for long periods of time to eat and is very easily distracted - think its just his nature unfortunately.

Re: Baby not eating. Lactation consultants stumped!

yamahama29 and jenk - thank you so much for the kind words of support. It makes a world of difference to know I'm not alone. If either of you have any other tips that come to mind, I'll be eager to hear them (or if you mind sharing your routine, yamahama?)

We continue to have good times and bad times. Sometimes it's clear that it's my supply that's the issue and sometimes it's just his mood - whether he's overtired, too sleepy or just impatient, he just won't nurse long enough. And then we have a few good sessions which motivate me to keep trying.

I really really appreciate the support from everyone. I'll keep at it...

Re: Baby not eating. Lactation consultants stumped!

What a champ you are!! You asked how long the galactagogues take to work. In my case, the fenugreek took about two weeks. Just FYI. Also, a big hug to your husband who sounds like an amazing support guy. Breastfeeding dads can make or break a tough nursing situation!